April 26, 2009

Heeding Warnings

Posted in Life, Technology tagged , , , , , , , , , at 11:27 pm by lindaslongview

warningtriangle

All too often, we hear “warnings” but proceed without heed.  Sometimes it is a small voice inside one’s head that says, “things do not add up,” sometimes it is a real warning (do not use lawnmower as hedge trimmer or bodily injury might result), and sometimes it is a recitation of all possible observed “rare events,” such as on drug labels.

Two weeks ago, my doctor prescribed me the antibiotic levofloxacin for a sinus infection.  As he prescribed it for me, he hestitated because I am an avid athlete and he said that it was known to be associated with spontaneous tendon rupture.  Although I was warned, once I felt better I did not think about that warning as I returned to my regular repertoire of sports.  Last Thursday morning, as I perilously dangled after I lost my footing on a V2 bouldering problem, I had to strain hard to regain my footing and overgripped my left hand/arm to finish the route.  Later that afternoon, I could no longer open my car door with my left hand and the previously faded memory of the “tendon rupture” warning had resurfaced.

When faced with warnings, there is a tendency to discount that which causes us to deviate from plan.  As busy humans (never enough time!) we are risk averse especially to the loss of time. We have an ability to proceed with any number of justifications:  the probability is small (rare event), the concern does not apply (no associated risk factors), and/or the risk is overstated, because we have not deliberately considered the unfavorable outcome’s impact on time.

Deliberately planning for undesirable outcomes based upon “warnings” is the long view approach.  By including contingency for the unexpected, we are more objective in dealing with risk.

I have since learned that strenuous sports activities predispose patients to quinolone-related tendon rupture [Gold and Igra, “Levofloxacin-Induced Tendon Rupture: A Case Report and Review of the Literature,” The Journal of the American Board of Family Practice 16:458-460 (2003)].  Yikes!  Had I been sufficiently deliberate to more fully understand the potential for tendon rupture and had planned for a twelve week (or more!) tendon recovery, I would not have been bouldering on Thursday morning.  Swimming would have been a much better long view choice!

The good news is that my elbow pain is already better (probably unrelated to the drug concern).  But, nevertheless, now that I know the full implications, I will not be placing high loads on my tendons while taking levofloxacin again!

I am duly reminded to take the long view and plan for contigency in order to be more objective in dealing with risk.  I hope you are too!